Malrotation and midgut volvulus presenting as malabsorption

Volvulus of the midgut associated with intestinal malrotation classically presents in early life with complete, or intermittent, high intestinal obstruction. We describe the case of a boy presenting at 16 months of age with a history of malabsorption and failure to thrive. The importance of considering this rare diagnosis in such cases is discussed.

The estimation of femoral condyle size. An important component in osteochondral allografts

An important component of successful osteochondral allograft surgery of the knee is securing a donor with a femoral condyle (FC) of the appropriate size. The purposes of the present investigation were to analyze the effect of femoral rotation on measurement of FC size and to determine if easily measured variables, such as manual caliper measurements, height, weight, and gender, are useful in matching donors and recipients. Three separate investigations were conducted to accomplish these purposes. The results indicated that femoral rotation has a significant negative effect on accurate sizing of the FC. Height and gender provide an acceptable prediction of femoral condyle size and can be used effectively in the donor selection process.

Inhibitory effect of TNF alpha antibodies on synovial cell interleukin-1 production in rheumatoid arthritis

The effect of tumour necrosis factor (TNF alpha) antibodies on synovial cell interleukin-1 (IL-1) production was investigated in 7 patients with rheumatoid arthritis and in 7 with osteoarthritis. Synovial cell IL-1 production was significantly reduced by anti-TNF alpha antibody in cultures from patients with rheumatoid arthritis, but antilymphotoxin antibody did not have this effect (except in 1 culture). In cultures from patients with osteoarthritis spontaneous IL-1 production was low, despite high concentrations of TNF alpha, and IL-1 production was not inhibited by anti-TNF alpha antibody. In rheumatoid arthritis, TNF alpha may be the main inducer of IL-1, and anti-TNF alpha agents may be useful in treatment.

Population and biochemical genetics of the human mitochondrial malic enzyme

The phenotypic variation of the mitochondrial malic enzyme (MEM) was examined in 121 brains and 46 heart tissue samples from the population of north-east England. There was no difference in gene frequency distribution between sexes and the two tissues. However, a significant variation has been observed in males compared with a Scottish study. The three common phenotypes of brain were partially purified on a DEAE Sephadex column. The kinetics, heat stability and dicumarol inhibition studies show no biochemical advantage for any of the phenotypes in human brain. The extensive polymorphism of MEM suggests a possible, yet unknown, selective factor for the spread of this polymorphism. With the existing evidence of regional and racial differences, the role of random genetic drift cannot be ruled out.

Conditioned taste aversions induced by phencyclidine and other antagonists of N-methyl-D-aspartate

Taste aversions can be conditioned in rats by a variety of psychoactive drugs, including those with reinforcing properties. Previous research, however, has not established clearly whether phencyclidine and related drugs are active in such procedures. The present study was carried out to investigate whether phencyclidine would induce a conditioned taste aversion and whether several other compounds (MK-801, the stereoisomers of NANM and ifenprodil) which, like phencyclidine, are known to antagonise the actions of N-methyl-D-aspartate (NMDA), would produce similar effects. When rats received injections of these compounds, after consuming a novel solution of saccharin, their subsequent consumption of the same solution decreased. The smallest doses of the different drugs which induced clear taste aversions were: phencyclidine 3 mg/kg, MK-801 0.3 mg/kg, (+)-NANM 10 mg/kg, (-)-NANM 3 mg/kg and ifenprodil 10 mg/kg. Thus, all the drugs were active. However, as neither the potencies nor the efficacies of the different compounds in inducing taste aversions correlated with their other behavioural effects or with their relative potencies in antagonising the effects of NMDA or in displacing phencyclidine from its binding sites, the mechanisms involved are unclear.

Effects of lipofuscin on in situ hybridization in human neuronal tissue

In situ hybridization is a highly sensitive technique for detecting nucleic acid sequences within tissues, and is frequently employed in neurovirology. However, this technique requires many appropriate controls in order to recognize and avoid potential artifactual hybridization. We have encountered abundant reaction to lipofuscin in neurons in human peripheral and central nervous systems, using various DNA probes, which could be misinterpreted as positive signals. This pseudohybridization reaction was resistant to treatment with RNase or DNase and was also present in tissue sections treated with hybridization mixture or nuclear autoradiographic emulsion in the absence of any radioactive probes. Characteristics used to distinguish between authentic in situ hybridization and the reaction to neuronal lipofuscin include cellular localization, color, margins and granular appearance, sensitivity to treatment with nucleases and the effect of exposure time on signal intensity. These guidelines should be used to avoid potential misinterpretation of in situ hybridization results with human tissue.

Effects of phencyclidine and other N-methyl-D-aspartate antagonists on the schedule-controlled behavior of rats

The behavioral effects of phencyclidine (PCP) were compared with those of several compounds known to antagonize the actions of N-methyl-D-aspartate using two patterns of schedule-controlled responding in rats. Rates of variable interval responding suppressed by punishment were increased greatly by the benzodiazepine chlorodiazepoxide and showed small increases after MK-801 [(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine] . However, no consistent increases in response rates were produced by PCP, by the stereoisomers of N-allylnormetazocine (NANM: SKF 10,047) or by the anti-ischemic drug, ifenprodil. Small doses of PCP did increase rates of unpublished variable interval responding, as did a low dose of MK-801. Timing behavior maintained by a differential reinforcement of low rate schedule was disrupted by all the compounds studied. Response rates were increased by at least one dose of PCP, MK-801, (+)-NANM and 3-(2-carboxypiperazine-4-yl)propyl-1-phosphonic acid. The effect of MK-801, however, was considerably greater than that of the other compounds. Ifenprodil and (-)-NANM did not increase rates of responding but, at high doses, produced decreases in reinforcement frequency indicating that efficient timing behavior had been disrupted. These results show that although PCP, MK-801 and (+)-NANM produce generally similar behavioral effects, there may also be some differences between the compounds, notably a more consistent effect of MK-801 on punished responding. These behavioral effects may be related to antagonism of N-methyl-D-aspartate but ifenprodil, which is also an N-methyl-D-aspartate antagonist, does not show a similar behavioral profile.

Chorea and myoclonus in the monkey induced by gamma-aminobutyric acid antagonism in the lentiform complex. The site of drug action and a hypothesis for the neural mechanisms of chorea

Experiments are described in which the gamma-aminobutyric acid (GABA) antagonist bicuculline was injected into the lentiform complex of conscious monkeys. Injections into either the lateral segment of the globus pallidus, or the medial part of the putamen, gave rise to chorea of the contralateral limbs and/or orofacial region. Control injections of vehicle alone were without effect. Injections of bicuculline into the lateral part of the putamen gave rise to contralateral myoclonus. The chorea produced by lateral pallidal or medial putaminal injections was virtually indistinguishable from the dyskinesia (chorea/ballism) which has been shown, in previous studies, to be induced by injection of GABA antagonists into the subthalamic nucleus. It is proposed that the primary site of action of the GABA antagonist in producing chorea, in the present studies, was the lateral segment of the globus pallidus. The mode of action is suggested to be interruption of GABAergic transmission from the striatum to the lateral pallidal segment. Since this also occurs in Huntington's disease, it is proposed that experimental chorea induced by this method in the monkey may be a useful model of the dyskinesia seen in Huntington's disease in man. Loss of influence of inhibitory striatopallidal fibres would lead to abnormally increased activity of lateral pallidal neurons. These in turn project to the subthalamic nucleus, upon which they have an inhibitory action. Dyskinesia is thus produced by physiological inhibition of the subthalamic nucleus, whose destruction, both in man and the monkey, is known to produce ballism. It is proposed that ballism and chorea share common neural mechanisms, both involving the loss of influence of the subthalamic nucleus on the medial segment of the globus pallidus.

The expression of an N-CAM serum fragment is positively correlated with severity of negative features in type II schizophrenia

The expression of a 70-kD serum fragment of the neural cell adhesion molecule (N-CAM) in schizophrenia is described. Schizophrenic patients (n = 40) were found to have statistically significant increases (p less than 0.0001) in serum N-CAM levels when compared to normal individuals (n = 26), and this could not be associated with age or sex. This difference was more marked (p less than 0.0001) between type II schizophrenics (n = 13) and normal individuals (n = 26) than when patients in the overlap group between type I and type II schizophrenia (n = 18) were compared to normal individuals (p less than 0.001). This difference remained significant (p less than 0.01) when overlap patients were compared to those of type II schizophrenia. Furthermore, schizophrenic patients with lower serum N-CAM proved to be better responders to neuroleptic therapy. We suggest that these elevated serum N-CAM levels reflect an increased synaptic turnover rate in this psychotic state.

Observational analysis of the effects of kappa opioid agonists an open field behaviour in the rat

An observational analysis of the effects of four kappa-opioid agonists on forward locomotion, rearing and grooming displayed by rats in a novel open field was undertaken. The doses of agonists used corresponded to those previously found to produce changes in food consumption. Ethylketocyclazocine (0.1 and 1 mg/kg), bremazocine (0.01 and 0.1 mg/kg) and tifluadom (0.3 and 3 mg/kg) exerted suppressant effects on all the activities monitored. Grooming behaviour appeared to be particularly sensitive to this action, being virtually abolished by the larger doses of these compounds. In contrast, the selective kappa agonist U-50,488H (0.1-3 mg/kg) only attenuated grooming at the two highest doses tested (1 and 3 mg/kg). None of the agonists tested produced stimulation of open field activity during the 1-h study. Reductions in activity occurred at doses previously found to increase and decrease food intake. It was therefore concluded that the hyperphagia induced by kappa agonists was not part of a more general behavioural activation, whilst reductions in food consumption probably result from a non-specific behavioural depression.

Is the discriminative stimulus produced by phencyclidine due to an interaction with N-methyl-D-aspartate receptors?

Rats were trained to discriminate phencyclidine (PCP) from saline at doses of 2 and 4 mg/kg, using a two-lever food reinforced operant technique. +/- N-allylnormetazocine (+/- SKF 10047), +5-methyl-10,11-dihydro-5H-dibenzo[A,D]cyclohepten-5,10-imine MK 801), 3-(2-carboxypiperazin-4-yl) propyl-1-phosphonic acid (CPP) and ifenprodil, which have been shown to antagonise the effects of N-methyl-D-aspartate (NMDA), were tested for their ability to give rise to PCP-appropriate responding. In rats trained at both doses of PCP, +/- SKF 10047 (2-12 mg/kg) and MK 801 (0.0125-0.2 mg/kg) produced dose-related responding on the lever associated with PCP injection. The relative potency of these two compounds was the same in the two groups of animals, but their absolute potencies to produce a PCP-like discriminative stimulus were dependent on the training dose of PCP. In contrast, neither the competitive NMDA antagonist CPP (4-20 mg/kg) nor the non-competitive antagonist ifenprodil (2-12 mg/kg) produced PCP-appropriate responding and ifenprodil (4 mg/kg) neither potentiated nor antagonised PCP. These findings are discussed in the light of the hypothesis that the behavioural effects of PCP are mediated via a reduction of neurotransmission at the NMDA-subtype of glutamate receptors.

Using perceived exertion to prescribe and monitor exercise training heart rate

We examined whether feedback of heart rate (HR) or HR combined with ratings of perceived exertion (RPE and HR) during a graded exercise test (GXT) and during early trials of field training would reduce the errors commonly seen when training heart rate range (THR) is self-monitored by participants. Asymptomatic males (n = 24) were tested on a Balke treadmill protocol in a randomized, between-groups design under control conditions or conditions where feedback about HR or HR combined with RPE were given as age-predicted THR was approximated. This was followed on alternating days by three field trials of an 800-m jog where errors between prescribed and attained THR were fed back to each subject. A priori 95% confidence intervals for the first field trial showed that signed (algebraic) error for the HR combined with RPE condition (+3 bts/min) was less than for controls (+23.5 bts/min). Feedback of HR alone was no different from the control condition. All groups showed increased accuracy (P less than .05) by the third field trial [absolute error: T1 (18 bts/min) to T3 (9.6 bts/min); signed error: T1 (+14 bts/min) to T3 (+4 bts/min)]. Our results suggest feedback of HR combined with RPE during a GXT may reduce an overshoot in THR during the first of subsequent exercise sessions. Feedback of HR alone appeared sufficient to further reduce THR errors after a third exercise session in the field. The procedures used may have practical importance for sedentary, unfit, or diseased individuals where conservative HR prescriptions are desirable but electronic monitoring is not feasible or cost effective.

CSF tryptophan and transmitter amine turnover may predict social behaviour in the normal rat

Central 5-hydroxytryptamine (5-HT) and dopamine (DA) turnovers and tryptophan concentrations were estimated in individual male rats using repeated CSF withdrawal. On subsequent pairing, the major biters of each pair (neck + body bites) were predicted by their higher concentrations of the 5-HT precursor tryptophan but not by 5-HT turnover. However, bites/pair correlated highly significantly with the lower 5-HT and DA turnover values in each pair. The investigation illustrates a new and flexible approach to the neurochemistry of social behaviour.

Detection of cerebral injury after total circulatory arrest and profound hypothermia by estimation of specific creatine kinase isoenzyme levels using monoclonal antibody techniques

New 2-site labeled monoclonal antibody techniques were used to measure serially plasma levels of brain-type creatine kinase (CK-BB), heart-type creatine kinase (CK-MB) and muscle-type creatine kinase (CK-MM) during a 20-hour postoperative period in 24 infants after deep hypothermia and total circulatory arrest used in pediatric cardiac surgery. A control group of 7 children undergoing cardiovascular procedures without extracorporeal circulation or circulatory arrest also were studied. There were marked increases in CK-MB and CK-BB levels in the circulatory arrest group but not in the closed group. CK-BB increased from 3.2 +/- 0.5 to 27 +/- 10 ng/ml and CK-MB from 5.9 +/- 2.1 to 137 +/- 12 ng/ml. The CK-MM concentrations increased from 299 +/- 91 and 194 +/- 49 ng/ml to 1,220 +/- 274 and 1,322 +/- 142 ng/ml in the closed and circulatory arrest groups, respectively. Peak levels of CK-MB and CK-BB occurred an average of 133 and 127 minutes, respectively, after reperfusion. The half-time of CK-BB differed significantly from that of CK-MB (149 +/- 15 vs 359 +/- 20 minutes). The arrest time had a more marked effect on CK-BB concentration than on CK-MB and CK-MM concentrations. Arteriointernal jugular venous concentration differences were consistently negative for CK-BB in the circulatory arrest group, but not for CK-MM and CK-MB.(ABSTRACT TRUNCATED AT 250 WORDS)

Ascorbic acid interference in reagent-strip reactions for assay of urinary glucose and hemoglobin

Vitamin C (ascorbic acid), commonly taken as a dietary supplement and excreted in the urine, can interfere with peroxidase redox indicator systems such as those used in reagent-strip tests for urinary glucose and hemoglobin. We investigated whether the concentrations of ascorbic acid in urine after modest supplementary doses of vitamin C are high enough to interfere with such dipstick tests. After adding glucose or hemoglobin to urine collected from persons not taking vitamin C and from persons taking 350 to 1000 mg of vitamin C daily, we tested four reagent strips for interference and found that these commonly taken doses did frequently interfere with all test systems examined.

Ascorbic acid interference in reagent-strip reactions for assay of urinary glucose and hemoglobin

Vitamin C (ascorbic acid), commonly taken as a dietary supplement and excreted in the urine, can interfere with peroxidase redox indicator systems such as those used in reagent-strip tests for urinary glucose and hemoglobin. We investigated whether the concentrations of ascorbic acid in urine after modest supplementary doses of vitamin C are high enough to interfere with such dipstick tests. After adding glucose or hemoglobin to urine collected from persons not taking vitamin C and from persons taking 350 to 1000 mg of vitamin C daily, we tested four reagent strips for interference and found that these commonly taken doses did frequently interfere with all test systems examined.

An observational analysis of the effect of the selective kappa opioid agonist, U-50,488H, on feeding and related behaviours in the rat

The behaviour of partially pre-satiated rats consuming a sweet palatable food and treated with either vehicle or the specific kappa receptor agonist U-50,488H (0.1-3 mg/kg) was recorded on videotape. Analysis revealed that the hyperphagia induced by the kappa agonist (0.3-3 mg/kg) resulted from an increase in the duration of feeding and not from an increase in the local rate of eating. The increase in duration was due, in turn, to a greater frequency of bouts of feeding. The kappa agonist also increased the latency to the final feeding bout. The effect of U-50,488H was consistent with de-satiation, so that the increase in feeding duration was in evidence from the start of the test period, while the temporal pattern of later satiation was preserved but lagged behind that of control animals. At the largest dose, other recorded activities (rearing, locomotor activity, grooming) were suppressed, with a marked increased in inactivity. At the lowest dose (0.1 mg/kg) there was a significant increase in grooming behaviour. The results are discussed with reference to an hypothesis of opioid function in the control of food intake.

Endorphins and food intake: kappa opioid receptor agonists and hyperphagia

Evidence from studies which utilise either opiate receptor agonists and antagonists strongly indicate a role for endorphinergic mechanisms in the control of feeding responses. Two means by which these compounds may exert an effect on feeding can be singled-out. Firstly, emerging evidence suggests that the process of achieving satiety (terminating a meal, or choice of a commodity) may be accelerated following treatments with opiate receptor antagonists. Secondly, the preference for highly palatable solutions (sweet solutions have received most attention) in two-bottle tests is blocked after injection of opiate receptor antagonists. This finding has been interpreted in terms of the abolition of the reward or incentive quality associated with the particularly attractive flavour. These two mechanisms of action may represent two aspects of a single, fundamental process. Following an introduction to rat urination model of in vivo kappa agonist activity, the consistent effect of several kappa agonists (including the highly selective U-50,488H) to stimulate food consumption is described. Recognising that members of the dynorphin group of endogenous opioid peptides are kappa receptor ligands, some with a high degree of selectivity, and the evidence the dynorphins and neo-endorphins produce hyperphagia in rats is particularly interesting. Such lines of evidence lead to the hypothesis that peptides of the dynorphin group may act endogenously to promote the expression of normal feeding behaviour.